tbuckley/cabot-search huggingface dataset:
Radiotherapy-induced vascular cognitive impairment 20 years after childhood brain tumor
Authors: Tiina Maria Remes, Maria Helena Suo-Palosaari, Pekka Matti Arikoski, Marika Harila, Päivi Katri Tuulikki Koskenkorva, Päivi Maria Lähteenmäki, Tuula Riitta Irmeli Lönnqvist, Marja Katariina Ojaniemi, Heli Pohjasniemi, Riina Puosi, Niina Ritari, Kirsti Helena Sirkiä, Anna Kaarina Sutela, Sanna-Maria Toiviainen-Salo, Heikki Markku Johannes Rantala, Arja Helena Harila
Journal: Neuro-Oncology (2023)

Abstract Background Studies have established that radiotherapy for childhood brain tumors (BTs) increases the risk of cerebrovascular disease (CVD); however, it is unclear how this will affect cognitive function. This study aimed to investigate the associations between radiotherapy-induced CVD, white matter hyperintensities (WMHs), and neurocognitive outcomes in adult survivors of childhood BTs. Methods In a cross-sectional setting, we conducted a national cohort that included 68 radiotherapy-treated survivors of childhood BTs after a median follow-up of 20 years. Markers of CVD and WMHs were evaluated using brain MRI, and the sum of CVD-related findings was calculated. Additionally, the associations among CVD findings, WMHs, and neuropsychological test results were analyzed. Results Of the 68 childhood BT survivors, 54 (79%) were diagnosed with CVD and/or WMHs at a median age of 27 years. CVD and/or WMHs were associated with lower scores for verbal intelligence quotient, performance intelligence quotient (PIQ), executive function, memory, and visuospatial ability (P &amp;lt; .05). Additionally, survivors with microbleeds had greater impairments in the PIQ, processing speed, executive function, and visuospatial ability (P &amp;lt; .05). WMHs and CVD burden were associated with greater difficulties in memory function and visuospatial ability (P &amp;lt; .05). Small-vessel disease burden was associated with PIQ scores, processing speed, working memory, and visuospatial ability. Conclusions The study results suggest that markers of radiotherapy-induced CVD, the additive effect of CVD markers, and risk factors of dementia are associated with cognitive impairment, which may suggest that the survivors are at a high risk of developing early-onset dementia.
PC-Reg: A pyramidal prediction–correction approach for large deformation image registration
Authors: Wenzhe Yin, Jan-Jakob Sonke, Efstratios Gavves
Journal: Medical Image Analysis (2023)

Deformable image registration plays an important role in medical image analysis. Deep neural networks such as VoxelMorph and TransMorph are fast, but limited to small deformations and face challenges in the presence of large deformations. To tackle large deformations in medical image registration, we propose PC-Reg, a pyramidal Prediction and Correction method for deformable registration, which treats multi-scale registration akin to solving an ordinary differential equation (ODE) across scales. Starting with a zero-initialized deformation at the coarse level, PC-Reg follows the predictor-corrector regime and progressively predicts a residual flow and a correction flow to update the deformation vector field through different scales. The prediction in each scale can be regarded as a single step of ODE integration. PC-Reg can be easily extended to diffeomorphic registration and is able to alleviate the multiscale accumulated upsampling and diffeomorphic integration error. Further, to transfer details from full resolution to low scale, we introduce a distillation loss, where the output is used as the target label for intermediate outputs. Experiments on inter-patient deformable registration show that the proposed method significantly improves registration not only for large but also for small deformations.
Artificial intelligence–based image analysis in clinical testing: lessons from cervical cancer screening
Authors: Didem Egemen, Rebecca B Perkins, Li C Cheung, Brian Befano, Ana Cecilia Rodriguez, Kanan Desai, Andreanne Lemay, Syed Rakin Ahmed, Sameer Antani, Jose Jeronimo, Nicolas Wentzensen, Jayashree Kalpathy-Cramer, Silvia De Sanjose, Mark Schiffman
Journal: JNCI Journal of the National Cancer Institute (2023)

Novel screening and diagnostic tests based on artificial intelligence (AI) image recognition algorithms are proliferating. Some initial reports claim outstanding accuracy followed by disappointing lack of confirmation, including our own early work on cervical screening. This is a presentation of lessons learned, organized as a conceptual step-by-step approach to bridge the gap between the creation of an AI algorithm and clinical efficacy. The first fundamental principle is specifying rigorously what the algorithm is designed to identify and what the test is intended to measure (eg, screening, diagnostic, or prognostic). Second, designing the AI algorithm to minimize the most clinically important errors. For example, many equivocal cervical images cannot yet be labeled because the borderline between cases and controls is blurred. To avoid a misclassified case-control dichotomy, we have isolated the equivocal cases and formally included an intermediate, indeterminate class (severity order of classes: case>indeterminate>control). The third principle is evaluating AI algorithms like any other test, using clinical epidemiologic criteria. Repeatability of the algorithm at the borderline, for indeterminate images, has proven extremely informative. Distinguishing between internal and external validation is also essential. Linking the AI algorithm results to clinical risk estimation is the fourth principle. Absolute risk (not relative) is the critical metric for translating a test result into clinical use. Finally, generating risk-based guidelines for clinical use that match local resources and priorities is the last principle in our approach. We are particularly interested in applications to lower-resource settings to address health disparities. We note that similar principles apply to other domains of AI-based image analysis for medical diagnostic testing.
The Q/R editing site of AMPA receptor GluA2 subunit acts as an epigenetic switch regulating dendritic spines, neurodegeneration and cognitive deficits in Alzheimer’s disease
Authors: Amanda L. Wright, Lyndsey M. Konen, Bruce G. Mockett, Gary P. Morris, Anurag Singh, Lisseth Estefania Burbano, Luke Milham, Monica Hoang, Raphael Zinn, Rose Chesworth, Richard P. Tan, Gordon A. Royle, Ian Clark, Steven Petrou, Wickliffe C. Abraham, Bryce Vissel
Journal: Molecular Neurodegeneration (2023)

RNA editing at the Q/R site of GluA2 occurs with ~99% efficiency in the healthy brain, so that the majority of AMPARs contain GluA2(R) instead of the exonically encoded GluA2(Q). Reduced Q/R site editing infcreases AMPA receptor calcium permeability and leads to dendritic spine loss, neurodegeneration, seizures and learning impairments. Furthermore, GluA2 Q/R site editing is impaired in Alzheimer's disease (AD), raising the possibility that unedited GluA2(Q)-containing AMPARs contribute to synapse loss and neurodegeneration in AD. If true, then inhibiting expression of unedited GluA2(Q), while maintaining expression of GluA2(R), may be a novel strategy of preventing synapse loss and neurodegeneration in AD.We engineered mice with the 'edited' arginine codon (CGG) in place of the unedited glutamine codon (CAG) at position 607 of the Gria2 gene. We crossbred this line with the J20 mouse model of AD and conducted anatomical, electrophysiological and behavioural assays to determine the impact of eliminating unedited GluA2(Q) expression on AD-related phenotypes.Eliminating unedited GluA2(Q) expression in AD mice prevented dendritic spine loss and hippocampal CA1 neurodegeneration as well as improved working and reference memory in the radial arm maze. These phenotypes were improved independently of Aβ pathology and ongoing seizure susceptibility. Surprisingly, our data also revealed increased spine density in non-AD mice with exonically encoded GluA2(R) as compared to their wild-type littermates, suggesting an unexpected and previously unknown role for unedited GluA2(Q) in regulating dendritic spines.The Q/R editing site of the AMPA receptor subunit GluA2 may act as an epigenetic switch that regulates dendritic spines, neurodegeneration and memory deficits in AD.
Leveraging TROP2 Antibody-Drug Conjugates in Solid Tumors
Authors: Blessie Elizabeth Nelson, Funda Meric-Bernstam
Journal: Annual Review of Medicine (2023)

Antibody-drug conjugates (ADCs) have become the cornerstone of effective therapeutics in solid and hematological malignancies by harnessing potent cytotoxic payloads with targeted tumoricidal delivery. Since the monumental shift occurred with HER2-targeted ADCs, the discovery of the TROP2 antigen has revolutionized the landscape of ADC development. Moving beyond the traditional ADC design, multiple novel ADCs have successfully shaped and improved survival outcomes in patients with various tumor histologies. Here we review and contrast the clinical impact of the well-known TROP2 ADCs currently in clinical use. We also shed light on upcoming investigational TROP2 ADCs showing promise with novel ADC platforms.
Percutaneous transhepatic digital single-operator cholangioscopy-guided laser lithotripsy in treating difficult intrahepatic duct stone in surgically altered anatomy
Authors: Alan Chuncharunee, Kesinee Yingcharoen, Manus Rugivarodom, Varayu Prachayakul
Journal: Endoscopy (2023)

Endoscopic intrahepatic duct (IHD) stone management in patients with surgically altered anatomy is a major technical challenge [1] [2].
Technical aspects of transpapillary biopsy for gallbladder cancer using a novel cholangioscope
Authors: Takeshi Ogura, Kimi Bessho, Nobuhiro Hattori, Mitsuki Tomita, Hiroki Nishikawa
Journal: Endoscopy (2023)

Cytology of bile juice obtained under endoscopic retrograde cholangiopancreatography (ERCP) guidance is the gold standard technique for obtaining histopathological evidence of gallbladder cancer. However, the diagnostic yield of this technique is insufficient. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has recently been performed for gallbladder lesions. However, because the gallbladder has a lumen, inadequate EUS-FNA can lead to bile leakage or cancer cell dissemination [1] [2]. Therefore, it is sometimes difficult to obtain histological tissue samples from gallbladder tumors. Although transpapillary gallbladder tumor biopsy under cholangioscopy guidance may be useful, the insertion of a cholangioscope into the gallbladder through the cystic duct is challenging. The recent introduction of a novel tapered cholangioscope (eyeMAX, Micro-Tech, China) may address these challenges ([Fig. 1]). The tip of this scope is significantly tapered, facilitating its smooth insertion into the target site. In addition, the scope features a working channel of 1.8 mm and a dedicated biopsy forceps, with a cup length of 1.6 mm, which enables the retrieval of large quantities of histological tissue. Herein we describe the technical aspects of the use of this scope for performing transpapillary biopsy of gallbladder cancer.
A combinatory vaccine with IMA950 plus varlilumab promotes effector memory T-cell differentiation in the peripheral blood of patients with low-grade gliomas
Authors: Atsuro Saijo, Hirokazu Ogino, Nicholas A Butowski, Meghan R Tedesco, David Gibson, Payal B Watchmaker, Kaori Okada, Albert S Wang, Anny Shai, Andres M Salazar, Annette M Molinaro, Jane E Rabbitt, Maryam Shahin, Arie Perry, Jennifer L Clarke, Jennie W Taylor, Mariza Daras, Nancy Ann Oberheim Bush, Shawn L Hervey-Jumper, Joanna J Phillips, Susan M Chang, Norbert Hilf, Andrea Mayer-Mokler, Tibor Keler, Mitchel S Berger, Hideho Okada
Journal: Neuro-Oncology (2023)

Abstract Background Central nervous system (CNS) WHO grade 2 low-grade glioma (LGG) patients are at high risk for recurrence and with unfavorable long-term prognosis due to the treatment resistance and malignant transformation to high-grade glioma. Considering the relatively intact systemic immunity and slow-growing nature, immunotherapy may offer an effective treatment option for LGG patients. Methods We conducted a prospective, randomized pilot study to evaluate the safety and immunological response of the multipeptide IMA950 vaccine with agonistic anti-CD27 antibody, varlilumab, in CNS WHO grade 2 LGG patients. Patients were randomized to receive combination therapy with IMA950 + poly-ICLC and varlilumab (Arm 1) or IMA950 + poly-ICLC (Arm 2) before surgery, followed by adjuvant vaccines. Results A total of 14 eligible patients were enrolled in the study. Four patients received pre-surgery vaccines but were excluded from postsurgery vaccines due to the high-grade diagnosis of the resected tumor. No regimen-limiting toxicity was observed. All patients demonstrated a significant increase of anti-IMA950 CD8+ T-cell response postvaccine in the peripheral blood, but no IMA950-reactive CD8+ T cells were detected in the resected tumor. Mass cytometry analyses revealed that adding varlilumab promoted T helper type 1 effector memory CD4+ and effector memory CD8+ T-cell differentiation in the PBMC but not in the tumor microenvironment. Conclusion The combinational immunotherapy, including varlilumab, was well-tolerated and induced vaccine-reactive T-cell expansion in the peripheral blood but without a detectable response in the tumor. Further developments of strategies to overcome the blood-tumor barrier are warranted to improve the efficacy of immunotherapy for LGG patients.
Successful closure of thoracogastric airway fistula with occluder devices and coils under fluoroscopic guidance
Authors: Yifan Li, Zongming Li, Yahua Li, Zhen Li, Kewei Ren
Journal: Endoscopy (2023)

The application of esophageal stent closure of fistulas is limited in application to thoracogastric airway fistulas due to changes in anatomical structure after surgery. Additionally, the unique location of three-branch orificium fistulas and large orificium fistulas can cause complications such as stent displacement and lax sealing [1] [2].
Digital single-operator cholangioscopy-guided endoluminal radiofrequency of an intraductal papillary mucinous neoplasia of the main pancreatic duct
Authors: Xin Deng, Jingwen Wang, Tong Mou, Long Pan, Bin Li, Chengyou Du, Qiao Wu
Journal: Endoscopy (2023)

A 64-year-old woman with a history of recurrent acute pancreatitis was referred for treatment of intraductal papillary mucinous neoplasia (IPMN) that was found during a computed tomography (CT) scan in a local hospital. Magnetic resonance cholangiography (MRCP) presented dilation of the main pancreatic duct and suspicious nodules in the main pancreatic duct ([Fig. 1]). Endoscopic retrograde cholangiopancreatography (ERCP) showed that the pancreatic duct was significantly dilatated and there seemed to be a cystic lesion at the head of the pancreas ([Fig. 2]). Further evaluation of digital single-operator cholangioscopy (DSOC) found that the pancreatic duct was full of thick, mucinous fluid, and a few of papillary neoplasms were located at the junction of the main branch and branches of the pancreatic duct in the head of the pancreas ([Video 1]). Tissues were obtained by biopsy forceps and histopathologically examined.
Addressing high placebo response rates in randomized clinical trials for hidradenitis suppurativa
Authors: Amit Garg, Nicole Mastacouris, John R Ingram, Andrew Strunk
Journal: British Journal of Dermatology (2023)

Journal Article Accepted manuscript Addressing High Placebo Response Rates in Randomized Clinical Trials for Hidradenitis Suppurativa Get access Amit Garg, Amit Garg Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, USA Corresponding author: Amit Garg, MD Email:amgarg@northwell.edu https://orcid.org/0000-0003-0886-6856 Search for other works by this author on: Oxford Academic Google Scholar Nicole Mastacouris, Nicole Mastacouris Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, USA Search for other works by this author on: Oxford Academic Google Scholar John R Ingram, John R Ingram Division of Infection and Immunity, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK https://orcid.org/0000-0002-5257-1142 Search for other works by this author on: Oxford Academic Google Scholar Andrew Strunk Andrew Strunk Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, USA Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, ljad375, https://doi.org/10.1093/bjd/ljad375 Published: 27 September 2023 Article history Received: 09 May 2023 Revision received: 31 July 2023 Accepted: 26 September 2023 Published: 27 September 2023
Reply to Kilincalp and Mottacki
Authors: Michael X. Ma, Michael J. Bourke
Journal: Endoscopy (2023)

See also: Comments on: “Effect of pre-resection biopsy on detection of advanced dysplasia in large nonpedunculated colorectal polyps undergoing endoscopic mucosal resection”Endoscopy 2023; 55(10): 975-975DOI: 10.1055/a-2085-5532
Endoscopic vacuum therapy for esophageal perforations: is it risk effective for every size of defect?
Authors: Francesco Vito Mandarino, Lorella Fanti, Alberto Barchi, Edoardo Vespa, Silvio Danese
Journal: Endoscopy (2023)

See also: Endoscopic vacuum therapy for esophageal perforation: a multicenter retrospective cohort studyEndoscopy 2023; 55(09): 859-864DOI: 10.1055/a-2042-6707 See also: Reply to Mandarino et al.Endoscopy 2023; 55(10): 972-972DOI: 10.1055/a-2070-5719
Using a through-the-scope tack and suture system in patients with gastrointestinal wall defects: an alternative option beyond endoscopic clipping
Authors: Lijun Jia, Yang Shi
Journal: Endoscopy (2023)

See also: Endoscopic management of gastrointestinal wall defects, fistula closure, and stent fixation using through-the-scope tack and suture system Endoscopy 2023; 55(08): 766-772DOI: 10.1055/a-2019-3652 See also: Reply to Jia et al.Endoscopy 2023; 55(10): 974-974DOI: 10.1055/a-2094-8008
Comments on: “Effect of pre-resection biopsy on detection of advanced dysplasia in large nonpedunculated colorectal polyps undergoing endoscopic mucosal resection”
Authors: Serta Kilincalp, Nima Mottacki
Journal: Endoscopy (2023)

See also: Effect of pre-resection biopsy on detection of advanced dysplasia in large nonpedunculated colorectal polyps undergoing endoscopic mucosal resectionEndoscopy 2023; 55(03): 267-273DOI: 10.1055/a-1896-9798 See also: Reply to Kilincalp and MottackiEndoscopy 2023; 55(10): 976-976DOI: 10.1055/a-2085-5872
Reply to Jia et al.
Authors: Arunkumar Krishnan, Shailendra Singh
Journal: Endoscopy (2023)

See also: Using a through-the-scope tack and suture system in patients with gastrointestinal wall defects: an alternative option beyond endoscopic clippingEndoscopy 2023; 55(10): 973-973DOI: 10.1055/a-2085-5594
Reply to Mandarino et al.
Authors: Lisanne M. D. Pattynama, Roos E. Pouw
Journal: Endoscopy (2023)

See also: Endoscopic vacuum therapy for esophageal perforations: is it risk effective for every size of defect?Endoscopy 2023; 55(10): 971-971DOI: 10.1055/a-2070-5524
Oral Anticoagulants Beyond Warfarin
Authors: Renske H. Olie, Kristien Winckers, Bianca Rocca, Hugo ten Cate
Journal: The Annual Review of Pharmacology and Toxicology (2023)

Direct oral anticoagulants (DOACs) have largely replaced vitamin K antagonists, mostly warfarin, for the main indications for oral anticoagulation, prevention and treatment of venous thromboembolism, and prevention of embolic stroke in atrial fibrillation. While DOACs offer practical, fixed-dose anticoagulation in many patients, specific restrictions or contraindications may apply. DOACs are not sufficiently effective in high-thrombotic risk conditions such as antiphospholipid syndrome and mechanical heart valves. Patients with cancer-associated thrombosis may benefit from DOACs, but the bleeding risk, particularly in those with gastrointestinal or urogenital tumors, must be carefully weighed. In patients with frailty, excess body weight, and/or moderate-to-severe chronic kidney disease, DOACs must be cautiously administered and may require laboratory monitoring. Reversal agents have been developed and approved for life-threatening bleeding. In addition, the clinical testing of potentially safer anticoagulants such as factor XI(a) inhibitors is important to further optimize anticoagulant therapy in an increasingly elderly and frail population worldwide.
Endoscopy International Open – recently published
Journal: Endoscopy (2023)

Comment on: Impact of ERCP simulator training on early ERCP learning curves of novice trainees: a cohort studyEndosc Int Open 2023; 11(08): E690-E696DOI: 10.1055/a-2114-2842 Comment on: Endoscopic features of low-grade dysplastic Barrett’sEndosc Int Open 2023; 11(08): E736-E742DOI: 10.1055/a-2102-7726 Comment on: Bowel cleansing effectiveness and safety of 1L PEG + Asc in the real-world setting: Observational, retrospective, multicenter study of over 13000 patientsEndosc Int Open 2023; 11(08): E785-E793DOI: 10.1055/a-2125-0025
Endoscopy E-Videos – recently published
Journal: Endoscopy (2023)

Comment on: Three different strategies to overcome dilation failures of the bougie cap for upper gastrointestinal refractory stricturesEndoscopy 2023; 55(S 01): E723-E724DOI: 10.1055/a-2081-9329 Comment on: Salvage endoscopic wide-field full-thickness resection of T2 rectal cancer with endoscopic submucosal dissection instruments, without defect closureEndoscopy 2023; 55(S 01): E751-E752DOI: 10.1055/a-2081-9081 Comment on: Tackling tack removal after use of the through-the-scope helix tack and suture device for stent fixationEndoscopy 2023; 55(S 01): E819-E820DOI: 10.1055/a-2094-9601 Comment on: Endoscopic ultrasound-guided modification of surgical anatomy (from Roux-en-Y gastrectomy to Billroth II-like anatomy) for endoscopic treatment of malignant biliary stenosisEndoscopy 2023; 55(S 01): E827-E828DOI: 10.1055/a-2095-2267
Should colorectal endoscopic submucosal dissection defects be closed just because we can?
Authors: Sophie Geyl, Jérémie Albouys, Marion Schaefer, Jérémie Jacques
Journal: Endoscopy (2023)

See also: A novel through-the-scope helix tack-and-suture device for mucosal defect closure following colorectal endoscopic submucosal dissection: a multicenter studyEndoscopy 2023; 55(06): 571-577DOI: 10.1055/a-1970-5528
ESGE news and upcoming events October 2023
Journal: Endoscopy (2023)

Could your research make an impact at THE flagship event in European endoscopy? Our call for abstracts is now open, with an earlier than usual deadline of November 23, 2023. Our top four abstracts will be featured in the opening session, travel grants will be awarded to top submitters 40 years old and younger, plus all accepted abstracts are published in the Endoscopy journal with an Impact Factor of 10.437.
Usefulness of inserting a modified single‐pigtail plastic stent into a metallic stent in endoscopic ultrasound-guided gallbladder drainage
Authors: Koichi Soga
Journal: Endoscopy (2023)

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) has emerged as an alternative drainage technique, especially for high-risk surgical patients [1]. Sequential insertion of the stent delivery system into the gallbladder is a crucial technical step for successful EUS-GBD [2] [3].
Two-point fixed pulley-traction method in endoscopic submucosal dissection for early gastric neoplasm
Authors: Tsubasa Takeuchi, Mitsuru Esaki, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa
Journal: Endoscopy (2023)

Endoscopic submucosal dissection (ESD) is a technically challenging procedure with substantial risk of intraoperative complications. Traction assistance is a promising strategy for simplifying ESD. Although multiple traction methods have been proposed [1] [2] [3] [4] [5], there is room for further optimization. We designed a novel traction method termed the two-point fixed pulley-traction method (TPPT), which is detailed below and illustrated in [Video 1].